Graduated: 2005
NPI: 1659528123
Practice Locations (2)
FLORIDA DEPARTMENT OF HEALTH
1105 E KENNEDY BLVD, HILLSBOROUGH COUNTY HEALTH DEP.
TAMPA, FL 336023511
81330780156401
UNIVERSITY MEDICAL SERVICE ASSOCIATION INC
4202 E FOWLER AVE
TAMPA, FL 336206750
Source: CMS National Downloadable File, September 2026.